Become a part of our caring community and help us put health first
 

The Provider Engagement leader develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement leader works on problems of diverse scope and complexity ranging from moderate to substantial.

The Provider Engagement leader represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

**INCUMBENT MUST RESIDE IN TIDEWATER REGION OF VIRGINIA.

Use your skills to make an impact
 

Required Qualifications

• A minimum of five years of healthcare or managed care experience, preferably in a primary care practice

• Operational experience with managing value-based contracts, population health, or other healthcare performance improvement

• Proven planning, preparation and presenting skills, with established knowledge of clinician reimbursement and bonus methodologies

• Demonstrated ability to manage multiple projects and meet deadlines

• Comprehensive knowledge of all Microsoft Office applications

• Advanced organizational skills and/or project management

• Ability to travel as needed

 

Preferred Qualifications

• Bachelor and/or Master's Degree

• Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses, and quality/bonus performance

• Comprehensive knowledge of Medicare policies, processes, and procedures

Additional information

• Remote Role

• Incumbent must be based in Tidewater Region of Virginia

• Role requires <50% local travel;  mileage reimbursement will be issued.

• Driver's License, Reliable Transportation, Insurance This role is part of Humana's Driver safety program and therefore requires an individual to have: 

• a valid state driver's license, 

• carry insurance in accordance with the state minimum required limits, or $25,000/$25,000/10,000 whichever is higher 
• and a reliable vehicle. 
• Attachments

Work at Home Statement

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's o